Under a liver failure (English: hepatic failure, liver failure) one understands the maximum severity of liver failure. It comes to a partial Loss of metabolic functions of the liver.
In the worst case all functions of the liver come to a standstill. At a terminal liver failure with loss of metabolic functions of the liver there is a life threatening situationthat requires immediate therapy. A hepatic coma result, which is caused by the accumulation of various metabolic products in the body.
If liver failure cannot be assigned to a cause (e.g. alcohol-toxic liver damage), it is recorded as a separate disease entity in the ICD:
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There are many diseases and substances that can cause liver failure. Some of them lead to chronic liver damage, others acutely damage the liver. There are diseases that damage the liver tissue as well as those that hinder blood flow to the liver. Both processes lead to a destruction of the liver function and thus to a failure of the metabolic functions. A list of all conceivable causes is very difficult, so the relevant clinical pictures and substances should be mentioned here.
Inflammatory liver diseases: Hepatotropic viruses, i.e. hepatitis B, hepatitis C and hepatitis D viruses, are an important cause. These lead to chronic hepatitis (inflammation of the liver) and consequently to liver cirrhosis, which leads to liver failure. Other inflammatory liver diseases that make up only a small proportion of the total number of patients with liver failure are:
$config[ads_text2] not foundToxic liver damage: The most common cause of liver cirrhosis, which can ultimately be accompanied by liver failure, is chronic alcohol abuse. Other causes of toxic liver damage are:
Other causes:
Read more on the topic: Functions of the liver
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$config[ads_text3] not foundLiver cancers are a possible cause of liver failure. Most malignant tumors of the liver are liver metastases from other primary tumors. Often there is a patient with a so-called hepatocellular carcinoma also one Cirrhosis of the liverso that liver function and remaining healthy tissue are restricted. Other cancers like Lymphoma, the cholangiocellular carcinoma or something Metastases from tumors of other organs can manifest in the liver and that Destroy liver tissue.
The malignant cancer leads to one Destruction of the liver tissue and one Worsening blood circulation of the liver cells. Especially inside HCCs (Hepatocellular carcinoma) come Areas of necrosis that arise from reduced blood flow.
The degenerate liver tissue Fulfills no more metabolic functions. Overall, the prognosis is rather poor, since advanced liver cirrhosis is often present, especially in HCC. The residual tissue that is still present, which is functional, is therefore very small and not sufficient to maintain adequate function. As a result, the therapeutic measures for advanced disease are very limited.
Alcohol probably does greatest risk factor for chronic liver disease and consequently it represents liver failure. In industrialized nations in particular, massive alcohol abuse is a widespread problem. In Germany about 2.5 million alcoholics are in need of therapy.
A chronic alcohol abuse leads to one alcohol toxic liver damage. The damage can be in three stages be classified, of which the first two are potentially still reversible. The last stage, alcohol-related cirrhosis of the liver, is the Damage no longer reversible. With such advanced liver damage, liver failure can occur, as mentioned above. If all conservative and interventional therapy methods fail, then only this remains Liver transplant as a last resort.
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The chronic alcohol abuse not only leads to direct damage to the liver tissue in the sense of liver cirrhosis, but also harbors this Risk of degeneration of the liver cells, from which a Liver cancer can result. This can also lead to liver failure. So there is an urgent duty to end the alcohol abuse!
Acute liver failure shows a classic triad of symptoms consisting of jaundice (yellowing of the skin and sclera), coagulation disorders and impaired consciousness. This triad of symptoms results from the fact that the metabolic functions of the liver can no longer be maintained. In addition to this triad of symptoms, there are also numerous other clinical signs that indicate liver failure. In the following, the type and development of the symptoms will be discussed in more detail.
Cancer can also lead to liver failure. Signs of cancer are symptoms that have persisted for a long time and started rather insidiously. Mention should be made of the so-called B symptoms, in which it becomes
$config[ads_text1] not foundThese symptoms are not directly related to liver failure. However, they are attributable to a liver cancer disease or liver metastases, which can ultimately lead to liver failure. Furthermore, liver tumors can cause unspecific symptoms such as loss of appetite, upper abdominal pain or jaundice (jaundice). However, the symptoms usually only show up very late in the course of the cancer.
An indication of an underlying cancer of the liver is a sudden worsening of an existing liver cirrhosis, which is known as decompensation. This is to be understood as liver failure and is associated with the above-mentioned symptoms such as ascites, impaired consciousness and jaundice.
Find out more at: Stages of cirrhosis of the liver
Liver failure represents a urgent indication for therapy It can sometimes be serious and in the worst case too serious in the case of liver failure fatal complications come because the liver fulfills vital metabolic functions that cannot be compensated by other organs. First of all, one distinguishes one symptomatic from one causal therapy of liver failure.
In symptomatic therapy, one tries to replace all important functions and metabolic products of the liver as far as possible and to stabilize the circulation. First of all, intensive medical monitoring is necessary, as this is an acutely life-threatening situation. The circulation is stabilized. A control of the blood sugar and a good setting of the value, as well as the substitution of important electrolytes are also essential for a stable circulation. Do not use drugs that are toxic to the liver. The intake is stopped immediately or switched to another medication. Alcohol leave is also absolutely necessary. Sufficient fluid intake and a balanced, sufficiently caloric diet are aimed for. Contrary to the old doctrine, a protein restriction in the diet is no longer recommended today. Furthermore, the following therapeutic indications result from the respective symptoms:
The causal therapy of liver failure depends on the one responsible for it Underlying disease:
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Ultimately, however, is around 50% of patients with hepatic insufficiency or failure at some point Liver transplant as healing therapy necessary. Some underlying diseases like that PBC (primary cheap cirrhosis) or the PSC (primary sclerosing cholagitis) can only be cured by this. The time to liver transplant can vary with a Liver dialysis be bridged.
At Cancer patients the therapy is based on the stage her cancer and that Degree of metastasis as well as the residual liver function. Both surgical and conservative procedures are possible. A liver transplant can only be carried out here if there is cancer without metastasis or vascular invasion.
By definition it will be different time intervals for liver failure Are defined. The Liver failure represents the maximum form, i.e. the worst severity of liver failure This means that liver failure essentially implies liver insufficiency. The time it takes to progress to hepatic insufficiency allows the division into: